JP2019504662A - Hand-controllable surgical lighting device system and method - Google Patents

Abstract

Exemplary lighting systems for use in performing ophthalmic surgical procedures are provided herein. The lighting system may include a body configured to be grasped by a user's hand. The body can include an exterior surface and an interior surface that defines an interior chamber. An exemplary illumination system is an elongate tubular member extending from a distal end of the body, the elongate tubular member having an illumination path within the lumen of the elongate tubular member, the body and the surgical console. And an illumination source coupled to an illumination path in the optical fiber extending therebetween. An exemplary lighting system may include a plurality of lighting controls disposed on the exterior surface of the body. The first illumination controller may allow a user to selectively control the adjustable illumination level between a high intensity state and a low intensity state.

Description

  The present disclosure relates to surgical devices, systems, and methods. More specifically, but not exclusively, the present disclosure relates to devices, systems, and methods that provide a controller for an illumination device for illuminating the interior of the eye during an ophthalmic surgical procedure.

  Microsurgical procedures often require precise cutting and / or removal of various body tissues. For example, certain ophthalmic surgical procedures require cutting and removing a portion of the vitreous humor, a transparent jelly-like material that fills the posterior segment of the eye. Vitreous humor or vitreous often consists of many fine fibrils attached to the retina. Therefore, vitreous amputation and removal must be done with great care to avoid retinal traction, retinal detachment from the choroid, retinal tears, or, in the worst case, amputation and removal of the retina itself. I must. In some delicate operations such as mobile tissue management (eg, cutting and removal of the vitreous near the retinal or retinal hiatus) and base incision of the vitreous, cutting and removing the membrane may be particularly difficult .

  Microsurgical procedures such as in the posterior segment of the eye typically require many incisions to access the interior of the eye. Each further incision can pose a risk of complications during treatment and / or recovery. During the procedure, various instruments are inserted through the incision for use by a user such as a surgeon or other medical professional. The primary of the various instruments is an illuminator that can be inserted through one of the incisions. The illuminator illuminates the surgical field. The placement of the illuminator within the operative field requires time and effort on the part of the user to properly place the illuminator and attach the corresponding cable to keep the illuminator stationary. In addition, as the surgeon progresses through the various steps of the surgical procedure, the lighting requirements can change. For example, the illumination may need to be attenuated briefly to allow the surgeon to view other aspects of the tissue in the eye.

  Current approaches to effecting changes in lighting require the surgeon to look away from the surgical field and interact with the surgical console to effect the desired change, or the surgeon communicates with the assistant, The assistant then needs to interact with the surgical console. Such actions can disrupt the flow of surgical procedures and can reduce the efficiency and effectiveness of the procedure.

  The present disclosure relates to exemplary illuminated microsurgical instruments and methods of using such instruments. The instrument may include a microsurgical instrument and an optical fiber for delivering light to the surgical site.

  Exemplary surgical systems are provided herein. An exemplary illumination system for use in performing an ophthalmic surgical procedure may include a body that may be configured to be grasped by a user's hand, and the body may include an exterior surface and an interior surface. The internal surface defines an internal chamber. An exemplary illumination system is an elongate tubular member extending from the distal end of the body, the elongate tubular member having an illumination path within the lumen of the elongate tubular member, the body, And an illumination source coupled to an illumination path in the optical fiber extending between the surgical console. An exemplary lighting system may include a plurality of lighting controls disposed on the exterior surface of the body. The first illumination controller may allow the user to selectively control the adjustable illumination level between a high intensity state and a low intensity state.

  Exemplary lighting devices are provided herein. One exemplary lighting device may be configured to provide illumination within a body cavity during a surgical procedure. An exemplary lighting device may include a body configured to be grasped by a user's hand. The body may include an exterior surface and an interior surface, and the interior surface may define an interior chamber. An exemplary lighting device may include an elongate tubular member extending from the distal end of the body. The elongate tubular member may have an illumination path within the lumen of the elongate tubular member. The exemplary lighting device may further include an illumination source coupled to the illumination path and disposed in the interior chamber and a first illumination controller disposed on the exterior surface of the body. The first illumination controller may allow the user to selectively control the adjustable illumination level between a high intensity state and a low intensity state.

  An exemplary method for adjusting the illumination used in ophthalmic surgery is for adjusting the illumination level provided by an illumination device that may have an elongate tubular member extendable into the vitreous chamber of the eye. The method may include receiving input from the user. The elongate tubular member may include an optic fiber that extends into the elongate tubular member and provides illumination to the vitreous chamber. The input may be received via a lighting control located on the external surface of the lighting device. An exemplary method is the step of transmitting an electrical signal to a surgical console, the surgical console including an illumination subsystem of the console such that the conditioned illumination reaches the vitreous chamber of the eye through an optical fiber. May further comprise the step of adjusting the illumination provided by.

  It should be understood that both the foregoing summary and the following detailed description are exemplary and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the disclosure. is there. In this regard, further aspects, features, and advantages of the present disclosure will become apparent to those skilled in the art from the accompanying drawings and the following detailed description.

  The accompanying drawings illustrate implementations of the devices and methods disclosed herein and together with the description serve to explain the principles of the present disclosure.

FIG. 3 shows a perspective view of an exemplary surgical system according to aspects of the present disclosure. 2 is a block diagram of subsystems and components of the exemplary surgical system of FIG. 1 in accordance with aspects of the present disclosure. FIG. Fig. 4 illustrates an illumination device in situ within an eye according to aspects of the present disclosure. FIG. 3 is a side view of an illuminated handpiece that may be used as part of the exemplary surgical system of FIGS. 1 and 2 according to aspects of the present disclosure. FIG. 3 is a side view of another implementation of an illuminating handpiece that may be used as part of the exemplary surgical system of FIGS. 1 and 2 according to aspects of the present disclosure. FIG. 6 is a side view of the lighting handpiece of FIG. 5 further including a block diagram of components included in the lighting handpiece according to aspects of the present disclosure. FIG. 6 is a side view of the lighting handpiece of FIG. 5 further including another block diagram of components included in the lighting handpiece according to aspects of the present disclosure. FIG. 6 is a side view of the lighting handpiece of FIG. 5 further including another block diagram of components included in the lighting handpiece according to aspects of the present disclosure. 2 is a method utilizing the exemplary surgical system of FIG. 1 in accordance with aspects of the present disclosure.

  BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings can be better understood with reference to the following detailed description.

DETAILED DESCRIPTION For the purposes of promoting an understanding of the principles of the disclosure, the implementation is illustrated in the drawings and a specific language is used to describe the implementation. However, it will be understood that it is not intended to limit the scope of the present disclosure. For example, some more specific implementations of the present disclosure are directed to lighting devices that can be used for ophthalmic surgical treatment. However, application of the principles of the present disclosure to illuminated devices that can be used for other surgical treatments is within the scope of the present disclosure. Any alterations and further improvements in the described devices, instruments, methods, and any further applications of the principles of the present disclosure are well contemplated as would normally occur to one of ordinary skill in the art to which this disclosure relates. In particular, some or all of the features, components, and / or steps described for one implementation are some or all of the features, components, and / or steps described for other implementations of the disclosure. It is fully considered that all may be combined. For simplicity, in some cases, the same reference numbers are used throughout the drawings to refer to the same or like parts.

  The present disclosure relates to surgical systems and devices that provide illumination within a body cavity. During the surgical procedure, the illumination device may provide illumination, whereby other devices may be used to treat the body cavity. Conventionally, the adjustment of illumination performed by such an illumination device is performed using a surgical console. Either the surgeon or assistant interacts with interface elements on the surgical console to adjust the lighting aspect, including the level or intensity of the lighting, the color of the lighting, and / or whether the lighting is on or off. .

  For example, during a surgical procedure performed in the eye, the surgeon may first use illumination to visualize the transparent vitreous body in the vitreous chamber of the eye. The surgeon may need to visualize the vitreous body to remove the vitreous body and provide access to the retina. As the surgeon moves toward the retina, it may be necessary to reduce the brightness of the illumination to compensate for further reflections from the retina. Using conventional instruments, the surgeon may need to look away from the microscope used for visualization of the surgical site and focus attention on the surgical console to adjust the illumination. Alternatively, the surgeon may verbally tell the assistant to ask the assistant to adjust the lighting. In any case, the person who adjusts the illumination does not visually recognize the surgical environment when the adjustment is performed.

  Implementations of the present disclosure have a body with a control that can be actuated by one or more hands or fingers present on the device itself, which allows the user to control the lighting level, lighting color, and / or It includes a surgical lighting device that may manipulate the state of the illumination source (ie, on or off). In some implementations, the lighting controller may interact with the surgical console or its subsystems to adjust the lighting. In other implementations, the lighting controller may interact with components of the lighting device itself. Combinations of such arrangements are also provided within the scope of this disclosure.

  By allowing the surgeon to make adjustments without looking away from the surgical site, the ease and quality of lighting adjustment can be improved. This can increase the efficiency and effectiveness of the various stages of the surgical procedure performed. In particular, the lighting may be easily adapted by experimenting with lighting settings to access and discover the lighting settings that are most suitable for the current requirements. Because the surgical field is observed at the same time as adjusting, immediate feedback on the quality of the adjustment may be provided compared to previous settings.

  FIG. 1 shows a surgical system 100 according to an exemplary implementation. Surgical system 100 includes a base housing or console 102 and a corresponding display screen 104 that may show data regarding the operation and performance of the system during a surgical procedure. In some implementations, the console 102 may be movable, including, for example, wheels 103 to facilitate movement as needed. In another implementation, the console 102 may not include wheels. Console 102 may include multiple subsystems that cooperate to allow the surgeon to perform various surgical procedures, such as ophthalmic surgical procedures. For example, the console 102 may include an illumination subsystem that includes a light source that generates light that can be directed into the body cavity to allow the surgeon to operate within the body cavity.

  An exemplary surgical lighting device, shown as handpiece 112, may be attached to console 102 and may form part of surgical system 100. In the illustrated implementation, the handpiece 112 is an illumination probe or device that is used to provide illumination in the eye to facilitate ophthalmic procedures. Handpiece 112 may be coupled to one or more subsystems included within console 102, such as a lighting subsystem (described in more detail in conjunction with FIG. 2). In some implementations, the handpiece 112 is further coupled to a vitrectomy subsystem that controls a pump and / or vacuum for use in vitreal removal. The vitrectomy subsystem may also provide power to the handpiece 112 and provide control of the handpiece 112. In some implementations, the handpiece 112 may be a vibratory vitreous cutter that includes a fixed outer elongated tubular member, a vibrating inner elongated tubular member, and an integral piece. With an integrated lighting feature. The system 100 may be used in various ophthalmic procedures such as anterior segment treatment, posterior segment treatment, vitreal retinal treatment, vitrectomy treatment, cataract treatment, and / or other treatments.

  Handpiece 112 is coupled to console 102 by conduit 108. In some implementations, the conduit 108 provides a fiber optic path that passes from the illumination subsystem of the console 102 to the handpiece 112 to provide an illumination path. In such an implementation, the conduit 108 may further include a communication line or wire that transmits a control signal from the handpiece 112 to the console 102. Such control signals may include attenuation control signals and / or illumination color adjustment signals. In addition, the control signal may include a signal that switches the lighting subsystem from an on state to an off state or from an off state to an on state.

  FIG. 2 is a block diagram of a surgical system 100 that includes a console 102 and several subsystems thereof. Some implementations of the surgical system 100 may omit one or more of the illustrated subsystems. The console 102 includes a computer subsystem 105, a display screen 104 (FIG. 1), and several subsystems. Several subsystems are used together to perform ocular surgical procedures such as, for example, emulsification or vitrectomy surgical procedures, and to provide illumination for these and other surgical procedures. . The computer subsystem 105 may include one or more processing devices, such as a central processing unit or central processor or microcontroller, and an information and data storage system. The data storage system may include one or more types of memory, such as random access memory (RAM), read only memory (ROM), flash memory, disk-based hard drives and / or solid state hard drives. The data storage system may store program instructions for performing the methods, functions, and operations described herein. The processing device and the storage system may communicate over a bus that also communicates with one or more of the plurality of subsystems of the surgical system 100 and one or more of the plurality of subsystems of the surgical system 100. Communication between the two may be possible.

  Surgical system 100 may include a handpiece subsystem 110 that includes a handpiece 112. The handpiece subsystem 110 communicates between the handpiece 112 and the computer subsystem 105 and allows the surgeon to use the handpiece 112 to control the different subsystems contained within the surgical system 100. To that end, signals from and to handpiece 112 may be received and / or encoded / decoded.

  An implementation of console 102 may include a lighting subsystem 120. The lighting subsystem 120 includes an attachment location 125 by which the conduit 108 couples the console 102 with the handpiece 112. The illumination subsystem 120 may include an illumination source 122. The illumination source 122 may include an incandescent bulb, a halogen bulb, a metal halide bulb, a xenon bulb, a mercury vapor bulb, a light emitting diode (LED), a white laser, combinations thereof, and / or other light sources. The illumination subsystem 120 may further include an attenuation system or attenuator 123 and one or more filters 124. Attenuator 123 may adjust the illumination level of illumination provided by illumination source 122. The filter 124 may change or adjust the lighting color configuration. For example, the filter 124 may include a band-pass filter that transmits light within a specific wavelength band. The filter 124 may include other filters that block a specific wavelength band.

  The handpiece 112 may include one or more controls that a user may use to communicate with the lighting subsystem 120 and some or all of its components. As illustrated, the handpiece 112 includes a first control unit 113 and a second control unit 114. The control unit 113 and the control unit 114 allow the user to adjust the level of illumination provided by the illumination subsystem 120, adjust the color configuration of illumination provided by the illumination subsystem 120, or turn on the illumination source 122. Or it may be placed on the outer surface of the handpiece 112 to allow it to be turned off. More detailed implementations of handpiece 112 and controller 113 and controller 114 are provided herein.

  Additional subsystems that may be included in the implementation of surgical system 100 are full including foot pedal subsystem 130 including foot pedal 132 and perfusion pump 144 connected to suction vacuum 142 and fluid conduit 146. And an idix subsystem 140. In implementations that include the fluidic subsystem 140, the fluid conduit 146 may provide a second connection to the handpiece 112, or a conduit such that one conduit 108 couples the handpiece 112 to the console 102. It may extend into the lumen in 108.

  Surgical system 100 may further include an imaging and control subsystem 150 having a communication module 152. The imaging and control subsystem 150 may facilitate communication between other subsystems, such as, for example, between the handpiece subsystem 110 and the lighting subsystem 120. The communication module 152 may provide wireless communication including wired communication and / or wireless communication such as Wi-Fi (Wireless Fidelity), Bluetooth, ZigBee, or Radio Identification (RFID) communication. In addition or alternatively, other implementations may be included in other implementations.

  In order to optimize the performance of different subsystems during surgery, their operating parameters can be specified, for example, whether the procedure is performed in the front or the back of the patient's eye. May vary according to the procedure, the different stages of the procedure, the surgeon's personal preferences and commands, etc.

  Different subsystems within the console 102 include control circuitry for the operation and control of each microsurgical instrument or instrument component, such as a component of the handpiece 112. The computer subsystem 105 appropriately provides information to the operator of the surgical system 100 to properly perform the ocular surgical procedure and via the display 104 and / or a coupled microscope or wearable computing device. Coordinate interactions and relationships between different subsystems to communicate.

  In addition, the console 102 includes one or more input devices that allow a user to select within a limited range to control or modify pre-programmed relationships between different subsystems. In this implementation, the input device may be built into the console, such as a foot pedal 132, a touch screen device that responds to selections made directly on the screen, a standard computer keyboard, and a mouse or trackball. Standard pointing devices (buttons, knobs, or other input devices are also contemplated). In the handpiece 112, the control unit 113 and the control unit 114 include one or more switches, knobs, touch sensors, sliders, to allow the user to also use the handpiece 112 as an input device for the console 102. It may include buttons, scroll wheels, clickable scroll wheels, and the like. A surgeon, scientist, or other user may use the input device to select or adjust parameters that affect the relationship between different subsystems of the console 102, such as the illumination subsystem 120. . Thus, based on user input, the user may change or adjust the relationship from what was coded on the console by the system programmer. In addition, the user may remap or reassign controls or other inputs according to the manner of treatment being performed. For example, instead of controlling the level of illumination provided by the illumination subsystem by controlling the illumination source 122 and / or attenuator 123, the user may control the color of the illumination by controlling the filter 124 and / or the illumination source 122. The foot pedal 132 may be operated to send a request to the imaging and control subsystem 150 to remap the control unit 114 and control unit 114 of the handpiece 112 to control. The foot pedal 132 may be operated again by the user to return to the previous mapping of the control unit 113 and the control unit 114.

  Other communications may be used to cause remapping of the control unit 113 and the control unit 114. For example, the function that can be controlled by the control unit 114 may be replaced or selected using the control unit 113. For example, the controller 113 may be operated to indicate that the signal from the controller 114 should be interpreted as turning on or off the illumination source 122. The controller 113 is operated again to interact with the filter 124 and / or the illumination source 122 itself so that the signal from the controller 114 is interpreted to indicate a modification of the illumination color configuration from the illumination subsystem. May be.

  Reference is now made to FIG. 3, which is a cross-sectional view of the eye 300. Eye 300 includes a vitreous chamber 302. A distal feature of handpiece 112 (described in more detail with subsequent figures) is inserted through an incision formed in sclera 304 of eye 300. The distal feature of handpiece 112 provides illumination 306 in the vitreous chamber. As shown in FIG. 3, the illumination 306 illuminates a portion of the vitreous chamber 302 and a portion of the retina 308 of the eye 300. The intensity and color of the lighting 306 may change as a user operates a control located on the outer surface of the handpiece 112 described herein. In operation, additional surgical devices may be introduced into the vitreous chamber 302 through further incisions made in the sclera 304. For example, in a vitrectomy procedure, a separate vitrectomy probe may be inserted through the sclera 304 to remove the vitreous from the vitreous chamber 302. Illumination 306 provided by handpiece 112 may allow a surgeon or other clinician to visualize the vitreous body to facilitate removal of the vitreous body. As the vitreous removal proceeds, the optimum illumination or color location required may change. The user may exert this change by using the control unit 113 and / or the control unit 114 as shown in FIG. As another example, a retinal manipulator may be inserted through the sclera 304. Illumination 306 may allow the surgeon to visualize the retina 308 to properly reposition the part (s) or part (s) and treat tears or detachments. If the reflection of illumination from the retina becomes too strong, the user can use the controller 113 and / or controller 114 to better visualize the portion of the retina 308 that is manipulated or otherwise treated. In addition, the color and / or intensity of the illumination may be changed. For example, a change in color and / or intensity (eg, from high intensity to low intensity) may reduce glare produced by reflection from the retina or one of the other surgical instruments used in the procedure. .

  FIG. 4 shows a side view of a lighting device 400 that may correspond to the handpiece 112 shown in FIGS. Illumination device 400 is configured and configured to be grasped by a user's hand, such as a surgeon, during a surgical procedure to provide illumination within a body cavity through a small entrance incision formed in its wall. A housing or body 402 is included. The body 402 may be formed from a rigid material such as a rigid polymer or metal. A user may manipulate the body 402 and thereby manipulate an elongate tubular portion 404 extending from the body 402. The body 402 may be a shell structure having an outer surface and an inner surface. The internal surface may define one or more chambers, and internal components of the lighting device 400 may be disposed and / or attached within the one or more chambers.

  The elongate tubular portion 404 may include multiple portions, through which the illumination may be moved and provided into the body cavity. As shown, the elongate tubular portion 404 includes an elongate collar 406 and a needle 408. The collar 406 may be a rigid elongate tubular member coupled to or formed as part of the body 402 to provide support to the needle 408. Needle 408 may also be rigid but more brittle than collar 406. In some implementations, the outer diameter of the needle 408 may be less than 4 mm (millimeters) or less than 3 mm. Needle 408 may be another elongate tubular member extending from body 402, a portion of which extends into and through collar 406.

  As shown in FIG. 4, the illumination path 412 extends into the distal end 410 of the needle 408. The illumination path 412 may be provided by an optical fiber or by a lumen having a highly reflective surface therein. In some implementations, the illumination path 412 is a portion of an optical fiber that extends from the console 102 to the distal end 410 of the needle 408. In other implementations, the illumination path 412 is a first optical fiber that extends into the elongate tubular portion 404 and the body 402 and couples to a second optical fiber that extends in the conduit 108 from the console 102 to the body 402. Although the distal tip of the illumination path 412 is shown as extending or protruding beyond the distal end 410 of the needle 408, the distal tip of the illumination path 412 is a needle into a body cavity such as the eye 300 of FIG. To protect the distal tip of the illumination path from damage that may occur during the insertion of 408, it may be recessed in the needle 408 by an offset distance in the range of about 1 μm (micrometer) to about 20 μm. . In addition, although the illumination path 412 is shown with the needle 408 housed, other implementations of the illumination device 400 may include an illumination path 412 secured to the outer surface of the needle 408.

  As illustrated in FIG. 4, the lighting device 400 includes a first control unit 420 and a second control unit 422. These may correspond to controller 113 and controller 114 that are used to adjust lighting parameters and other features of system 100. As illustrated, the first control unit 420 and the second control unit 422 may be scroll wheel type control units that allow the user to provide input from various inputs. For example, the first control unit 420 may be operated with a user's finger in order to change the intensity of illumination between a completely on state and a completely off state. In some implementations, the first controller 420 may be scrolled or moved about its axis to change the intensity of illumination. For example, the signal generated by the first controller 420 may be used to adjust the intensity of illumination directed by the user to provide optimal illumination within the eye 300, such as the attenuator 123 of the illumination subsystem 120 of FIG. May be transmitted. The first controller 420 may be “clicked” or pushed so that its axis of rotation moves orthogonally from the default position and generates a signal. This click input may be used to turn on or turn off the illumination source of the lighting device 400. In some implementations, the illumination source of the illumination device 400 may be an illumination source 122 as shown in FIG.

  The second controller 422 may be operated with a user's finger to adjust the color configuration of the illumination generated by the illumination source. For example, the second controller 422 interacts with the filter 124 of the illumination subsystem 120 (FIG. 2) and adjusts the bandpass filter between the high and low wavelengths of the light generated by the illumination source 122. Also good. In some implementations, the second controller 422 may interact with the filter 124 to adjust the range of wavelengths that can be transmitted through the bandpass filter. The second controller 422 is also clickable that allows the user to exert a change in lighting by clicking on the second controller 422 in addition to scrolling the second controller 422. A scroll wheel may be used. For example, the user may click or push on the second control 422 to engage or disengage the filter 124 of the lighting subsystem 120.

  The body 402 of the illumination device 400 may include an end portion 403 that serves to couple the illumination probe to the conduit 405. The conduit 405 may be the conduit 108 shown in FIG. Accordingly, the conduit 405 may mechanically couple the lighting device 400 to the console 102. In addition, the conduit 405 provides power to the lighting device 400 and receives signals from the first control unit 420 and the second control unit 422 and further controls included in some implementations of the lighting device 400. An electric wire or a wire may be included.

  In some implementations, the lighting device 400 may include other components that provide additional functionality for performing surgical procedures within a body cavity. For example, some implementations of the lighting device 400 may incorporate a vitrectomy needle. For example, needle 408 may include an integrated vitrectomy needle that may be actuated to remove the vitreous from vitreous chamber 302 of eye 300 of FIG. In such an implementation, the needle 408 may include an outer elongate tubular portion and an inner elongate tubular member that vibrates relative to the outer elongate tubular member within the outer elongate tubular member. . In such an implementation, during the vitrectomy procedure, the illumination path 412 is either within the outer elongate tubular member or the outer elongate tubular member to prevent the illumination path 412 from contacting the vibrating inner tubular member. It may be arranged along. The illumination path 412 may provide illumination within the vitreous chamber 302 to allow the surgeon to view the vitreous as the vitreous is removed by the vitrectomy needle.

  In some other implementations, the needle 408 may include a port or opening (not explicitly shown) at the distal end 410 to allow perfusate to be introduced into the body cavity. For example, the perfusate may be used to keep the tip of the illumination path 412 clean during a surgical procedure or to clean an imaging device disposed near the distal end 410 of the needle 408. , May flow through the needle 408. The perfusate may also be used to maintain an appropriate pressure level in the eye 300 during ophthalmic surgical procedures. Thus, the implementation of the lighting device 400 may incorporate additional surgical instruments and functions. This may reduce the number of incisions made in the surface or wall of a body cavity, such as the sclera 304 of the eye 300, during a surgical procedure.

  Referring now to FIG. 5, shown in this figure is another implementation of the lighting device 400. As shown in FIG. 5, the illumination probe includes a body 402 and an elongate tubular portion 404, where the elongate tubular portion 404 includes a collar 406, a needle 408, and the elongate tubular portion 404. And an illumination path 412 extending thereon. The illumination device 400 of FIG. 5 includes an illumination control unit 520 and an illumination control unit 522. As illustrated, the illumination control unit 520 and the illumination control unit 522 may be touch-sensitive control panels. Each of the illumination control unit 520 and the illumination control unit 522 may include a plurality of capacitance portions configured in a linear arrangement. The lighting controller 520 and the lighting controller 522 may be used to vary between the lighting and / or color extremes by tapping or swiping the controller 520 and controller 522. In addition, a two position switch or button 524 (also referred to as a lighting control 524) is disposed on the outer surface of the body 402. The internal surface of the body 402 defines an internal chamber, which may include components that facilitate control of illumination and / or control of other surgical instruments. Button 524 may be used to toggle between two lighting states, such as an on state and an off state. Signals generated by the control unit 520, the control unit 522, and the button 524 (also referred to herein as a lighting control unit) may be communicated to the console 102 by wireless or wired communication. The signal may be received at the handpiece subsystem 110 and may be communicated to the imaging and control subsystem 150 through the computer subsystem 105 bus. The communication module 152 may receive a signal. The signal may be interpreted or decoded by the imaging and control subsystem 150 and associated with the illumination subsystem 120 by the computer subsystem 105. The illumination subsystem 120 may communicate control signals to the illumination source 122, attenuator 123 and / or attenuator 124 as appropriate.

  Referring now to FIG. 6, shown in this figure is a lighting device 400 according to the implementation shown in FIG. Accordingly, a side view of the lighting device 400 is shown. In addition, FIG. 6 includes a window 600 showing a block diagram of components that may be housed within the interior chamber of the body 402 of the lighting device 400. As shown in FIG. 6, a communication link 602 may couple the illumination controller 520, the illumination controller 522, and the button 524 to the microcontroller 604. Some implementations of the lighting device 400 may not include the microcontroller 604. In such an implementation, communication link 602 may be a wire that extends within conduit 405 to console 102 of FIG. In such an implementation, the console 102 may directly receive electrical signals generated by the lighting controllers 520-524.

  As shown, the microcontroller 604 may receive electrical signals generated by the lighting controllers 520-524. The microcontroller 604 may generate a control signal (which may be an analog control signal or a digital control signal) based on the electrical signal received from the illumination control units 520 to 524. The lighting device 400 may include an internal power source 606, which may supply power to the lighting control units 520-524 so that the lighting control units 520-524 may generate electrical signals. The internal power source 606 may be a battery, a capacitor, or another suitable power source. In addition, the power source 606 may supply power to the microcontroller 604.

  As shown in FIG. 6, the illumination path 412 may be an optical fiber that extends from the distal end 410 of the needle 408 through the body 402 (as seen in the window 600) and the conduit 405 back to the console 102. . The illumination path 412 may be coupled to the illumination source 122 at a mounting location 125 on the console 102. The implementation of the lighting device 400 shown in FIG. 6 includes an attenuator 608 and a color filter 610 disposed within the body 402. In such an implementation, the illumination provided by the illumination source 122 of the illumination subsystem 120 (FIG. 1) may be communicated to the body 402 by the illumination path 412. Within the interior chamber of the body 402, the intensity of the illumination may be changed by the attenuator 608 and the color configuration of the illumination may be changed by the color filter 610. Accordingly, the signals received from the control unit 520 and the control unit 522 are received by the microcontroller 604 through the communication link 602, and as a control signal, the attenuator 608 for changing the illumination and the color configuration of the illumination are changed. May be relayed to the color filter 610. In some implementations, the attenuator 608 is provided by a neutral density filter or another feature that limits or redirects a portion of the illumination emitted by the illumination source 122 to the illumination path 412.

  As shown in FIG. 6, the window 600 includes a block showing a wireless transmitter 612. As shown in FIG. 2, the wireless transmitter 612 may communicate with the communication module 152. In implementations that do not include the attenuator 608 and the color filter 610, signals from the lighting controllers 520-524 may be transmitted to the console 102 by the wireless transmitter 612. Corresponding control signals may be relayed to appropriate components of the lighting subsystem 120 to implement the desired adjustment of lighting. In implementations that include an attenuator 608 and a color filter 610, the signal from the button 524 is transmitted to the console 102 by the wireless transmitter 612 to change the illumination source 122 from an on state to an off state or from an off state to an on state. May be sent.

  Referring now to FIG. 7, illustrated is another implementation of lighting device 400. The implementation of FIG. 7 is a side view of a lighting device 400 that includes a window 700 showing a block diagram of the components contained within the interior chamber of the body 402. As shown in FIG. 7, the illumination controllers 520-524 may communicate with the microcontroller 704 through the communication link 702. Microcontroller 704 may be powered by a power source 706. Unlike the implementation shown in FIG. 6, the implementation of the lighting device 400 shown in FIG. 7 includes a light source 708 disposed within the interior chamber of the body 402. In such an implementation, the illumination source 122 of FIG. 2 may be omitted. The microcontroller 704 may receive electrical signals from the lighting controllers 520-524 and interacts with the light source 708 to generate corresponding control signals for turning the light source 708 on and off and adjusting its intensity. May be. Some implementations may include a separate attenuator. The light source 708 may be a light emitting diode (LED) such as a white LED, an incandescent bulb, or another suitable light source. In general, the amount of power required by the light source 708 may be less than the amount of power required by the illumination source 122 of the illumination subsystem 120 shown in FIG. This is because the heat generated by the light source 708 in or around the lighting device 400 can be more difficult to dissipate than the heat generated by the illumination source 122 in or around the console 102. An implementation of lighting device 400 that includes light source 708 may be coupled to light source 708 and include fans and / or cooling fins that assist in the dissipation of the generated heat. The microcontroller 704 may further interpret an electrical signal received from one or more of the illumination controllers 520-524 and send a control signal to the color filter 710 disposed along the illumination path 412.

  As shown in FIG. 7, the lighting device 400 communicates with the console 102 via a wired communication link 712 (a microcontroller 704 may be coupled to the console 102 via a conduit 405) or a wireless transmitter 714. May be. In implementations that include a light source 708 and a color filter 710 within the interior chamber of the body 402, the communication link 712 and / or the wireless transmitter 714 may be used for further surgical instrument and feature operation included in the lighting device 400. Communication with the console may be facilitated. For example, the illumination controls 520-524 may be used to control the light source 708 and the color filter 710, while other controls located on the exterior surface of the body 402 can be used to control the pulse rate of the vitrectomy needle. Or it may be used to control the flow of perfusate. In some implementations, one or more of the illumination controllers 520-524 may be used as a controller for one or more such surgical instruments.

  The controls 520-524 may be remapped between one surgical function and another surgical function of the lighting device 400. In some implementations, the two-position button 524 may be a sliding two-position button, which allows the surgeon to control the illumination controller 520 and the illumination controller 522 to control other aspects of the illumination device 400. You may remap. For example, in the first position of the two-position button 524, the signal from the illumination controller 520 and / or the illumination controller 522 received by the microcontroller is used to control the light source 708 and / or the color filter 710. Also good. In the second position of the two-position button 524, the microcontroller 704 may generate a control signal that is used to interact with the vacuum 142 and / or the pump 144 of the fluidics subsystem 140. Relayed or transmitted to 102. Accordingly, the lighting controller 520 and the lighting controller 522 may be remapped to allow the user to control further functions of the integrated lighting device 400. Some implementations may include a three position button 524 that may be used to remap the controls of three different instruments within the lighting device 400.

  Referring now to FIG. 8, shown in this figure is yet another implementation of lighting device 400. The implementation shown in FIG. 8 shares many of the features described with respect to the implementation shown in FIGS. Window 800 shows a block diagram of components included in the implementation of lighting device 400 of FIG. The illumination controller 520 may include an electrical probe or conductor 802 that extends away from the generally flat surface of the illumination controller 520. Actuation of lighting control 520 by the user's finger causes conductor 802 to couple first radio identification (RFID) antenna component 804A to second RFID antenna component 804B (collectively referred to as RFID component 804). Also good. An RFID reader may be placed in the surgical environment where the lighting device 400 is used. The RFID reader may transmit power to the RFID component 804 wirelessly. The RFID component 804 may respond with a signal read by the RFID reader. The signal depends on whether the first RFID antenna component 804A and the second RFID antenna component 804B are coupled by a conductor 802. Thus, the user may depress illumination controller 520 to couple RFID antenna component 804A and RFID antenna component 804B, causing a change in the signal emitted by overall RFID component 804. The change in signal may be communicated to surgical system 100. For example, the communication module 152 may be an RFID reader that is arranged to detect changes in the signal generated by the RFID component 804. When a change in signal is detected, the imaging and control subsystem 150 may communicate to the illumination subsystem 120 to change the illumination source 122 from an on state to an off state or from an off state to an on state. Other signals received from illumination controller 522 and illumination controller 524 may be interpreted by microcontroller 806 to generate control signals for attenuator 808 and / or color filter 810. As another example, the change in signal generated by the RFID component 804 generates an attenuator control signal that causes the attenuator 123 to increase or decrease the intensity setting of the illumination subsystem 120 by the imaging and control subsystem 150. May be interpreted as follows. Some implementations of the lighting device 400 shown in FIG. 8 may further include a wireless transmitter 812 and a power source 814 as described herein with respect to other implementations of the lighting device 400.

  Combinations of features and functions described herein with respect to the various implementations shown and described with respect to FIGS. 4, 5, 6, 7, and 8 will be apparent to those skilled in the art from the disclosure. It can become clear after careful consideration. Such combinations are within the scope of this disclosure. For example, an implementation of the lighting device 400 may include a clickable scroll wheel such as the controller 420 and a capacitive touch controller such as the controller 522.

  Referring now to FIG. 9, shown in this figure is a lighting device and / or handpiece 112, such as an implementation of the lighting device 400 described herein and shown in FIGS. Is a method 900 of using As shown in FIG. 9, method 900 includes multiple steps or operations. Implementations of method 900 may include additional steps or operations before, after, during, or as part of the listed operations shown in FIG. In addition, some implementations of method 900 may omit one or more of the listed actions.

  At reference numeral 902 (FIG. 9), an illumination device is inserted into the body cavity. For example, a portion of the handpiece 112 may be inserted through an incision formed in the sclera 304 and a portion of the handpiece 112 may be placed in the vitreous chamber 302 of the eye 300 (FIG. 3). In implementations of handpiece 112, such as lighting device 400 of FIGS. 4-8, needle 408 is inserted through the sclera 304 so that illumination path 412 can provide illumination 306 into vitreous chamber 302. Also good.

  At reference numeral 904 (FIG. 9), input may be received from the user to adjust the lighting level provided by the lighting device. For example, the lighting device 400 may include a rigid needle 408 that protects the illumination path 412 and facilitates its careful positioning. The illumination path 412 may be an optical fiber, coupled to either the illumination source 122 of FIG. 2 or a light source 708 housed within the body 402 of the illumination device 400 to provide illumination 306 in the eye 300 (FIG. 3). May be. The input may be received via an illumination controller, such as one or more of illumination controllers 520-524 (FIG. 5) or illumination controllers 420 and 422 (FIG. 4).

  At reference numeral 906 (FIG. 9), an electrical signal is transmitted based on the input of reference numeral 904. The electrical signal may be sent to a surgical console such as the surgical console 102 of FIGS. The electrical signal may be sent directly from the lighting controller through a wire or communication link, or in other implementations the electrical signal is received by the microcontroller, interpreted by the microcontroller, and sent to the control signal (console 102). It may be an electrical signal). The control signal may be transmitted wirelessly via a wireless transmitter, such as the wireless transmitter 714 of FIG. 7, or the control signal may be wired communication such as a communication link 712 that extends from the microcontroller through the conduit 405 to the console 102. It may be transmitted over a link.

  At reference numeral 908 (FIG. 9), the electrical signal received by the surgical console 102 causes the adjusted illumination to pass through the illumination path 412 to the vitreous chamber 302 of the eye 300 of FIG. The lighting provided by the 102 lighting subsystems 120 may be adjusted by the surgical console.

  In some implementations, one of the transmitted electrical signals may include a request to remap the other transmitted electrical signal to control the second lighting aspect instead of the first lighting aspect. Good. For example, the controller 524 (FIG. 5) may be pressed by the user of the lighting device 400 and a corresponding signal may be sent to the console 102. Console 102 may interpret the signal as a request to remap controller 522 from control of attenuator 123 to control of filter 124. In other implementations, the request to remap the transmitted electrical signal may be a request to remap the electrical signal to control aspects of the lighting device 400 other than the lighting aspect. For example, the user may press the controller 524 to cause the controller 520 and controller 522 to control a perfusate system such as the fluidic subsystem 140 rather than the illumination subsystem 120.

  In addition, some implementations of method 900 may include detecting a change in the RFID signal. A change in the RFID signal may be generated if the lighting control includes a conductor, such as the conductor 802 of FIG. 8, that couples and separates a portion of the RFID component 804 to change the RFID antenna. Changes in the RFID signal may be detected by an RFID reader, such as the communication module 152. The change in the RFID signal may be interpreted as a request to adjust aspects of the illumination subsystem 120 described herein.

  Implementations of the present disclosure may include a handheld lighting device that includes an integrated lighting controller. A method of using such a device is also described herein. By interacting with the illumination source through a controller on the exterior surface of the handheld lighting device, the surgeon may be able to more carefully control the illumination to optimize visualization at a particular stage of the surgical procedure. The surgeon communicates with the assistant and asks the assistant to make such a change, and rather than looking away from the surgical site and interacting with the console to perform the change, the intensity and / or color configuration It is also possible to directly control the lighting mode. Thus, the implementation of the present disclosure can make surgical procedures more efficient and more effective.

  Although illustrative implementations have been shown and described in this regard, a wide range of modifications, changes and substitutions are possible in the foregoing disclosure. It will be understood that such changes may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly and in a manner consistent with the present disclosure.

Claims (21)

An illumination system for use in performing an ophthalmic surgical procedure comprising:
A body configured to be grasped by a user's hand, the body including an exterior surface and an interior surface, the interior surface defining an interior chamber;
An elongate tubular member extending from a distal end of the body, the elongate tubular member having an illumination path within a lumen of the elongate tubular member;
An illumination source coupled to the illumination path in an optical fiber extending between the body and a surgical console;
A plurality of illumination controllers disposed on the exterior surface of the body, wherein the first illumination controller selectively controls the illumination level adjustable between a high intensity state and a low intensity state by the user; A plurality of lighting control units, which can be controlled
Including lighting system.   And further comprising a microcontroller for receiving a signal from the illumination controller disposed on the exterior surface of the body, the microcontroller generating a control signal and transmitting the control signal to the surgical console. Item 2. The lighting system according to Item 1.   The illumination system of claim 2, wherein the console includes an illumination subsystem, the illumination subsystem including an illumination attenuator and an illumination color adjustment mechanism. A microcontroller for receiving signals from the illumination controller disposed on the external surface of the body;
An illumination attenuator disposed in the internal chamber and coupled to the microcontroller, the microcontroller receiving the signal received from the illumination controller disposed on the external surface of the body; Generating an attenuator control signal based on, the illumination attenuator adjusting an illumination level according to the attenuator control signal;
The lighting system according to claim 2, further comprising:   A color filter disposed in the internal chamber and coupled to the microcontroller, the microcontroller generating an illumination color adjustment signal in response to a signal received from the illumination controller; 5. The illumination system of claim 4, wherein the color filter adjusts the color composition of light generated by the illumination source by a color adjustment signal.   The illumination system of claim 1, wherein the illumination path includes a further optical fiber connected to the optical fiber to receive illumination from the illumination source.   The wireless transmitter further comprising a wireless transmitter disposed within the internal chamber, the wireless transmitter being coupled to the illumination controller and transmitting a signal received from the illumination controller to the surgical console. The illumination system according to 1.   8. The illumination system of claim 7, wherein the wireless transmitter is a passive radio identification (RFID) component, and activation of one of the illumination controls causes an antenna change of the RFID component.   The lighting controller extends between the lighting controller and the lighting subsystem so that a signal generated by the lighting controller is transmitted to a microcontroller included in the lighting subsystem. The illumination system of claim 1, coupled to the illumination subsystem of the surgical console by:   The lighting system according to claim 1, wherein the plurality of lighting control units includes a plurality of capacity portions for receiving user input on the main body. An illumination device configured to provide illumination within a body cavity during a surgical procedure,
A body configured to be grasped by a user's hand, the body including an exterior surface and an interior surface, the interior surface defining an interior chamber;
An elongate tubular member extending from a distal end of the body, the elongate tubular member having an illumination path within a lumen of the elongate tubular member;
An illumination source coupled to the illumination path and disposed within the internal chamber;
A first illumination controller disposed on the outer surface of the body, allowing a user to selectively control an adjustable illumination level between a high intensity state and a low intensity state. A first lighting control unit;
Including lighting devices.   And a microcontroller for receiving signals from a plurality of illumination controllers disposed in the interior chamber and disposed on the exterior surface of the body, the illumination controller comprising the first illumination The lighting device according to claim 11, comprising a control unit.   An illumination attenuator disposed in the internal chamber and coupled to the microcontroller, the microcontroller comprising: a first of the plurality of illumination controllers disposed on the external surface of the body. The lighting device according to claim 12, wherein an attenuator control signal is generated based on a signal received from two illumination control units, and the illumination attenuator adjusts an illumination level according to the attenuator control signal.   A color filter disposed in the internal chamber and coupled to the microcontroller, the microcontroller adjusting illumination color in response to a signal received from one of the plurality of illumination controllers; 13. The lighting device of claim 12, wherein the lighting device generates a signal and the color filter adjusts the color composition of light in the lighting path according to the lighting color adjustment signal.   The elongate tubular member includes an external member and an internal member, and the internal member is connected to a vibrator, and the vibrator vibrates the internal member with respect to the external member, and 12. The lighting device of claim 11, wherein the lighting device cuts material received in a port formed at the distal end.   The lighting device according to claim 11, further comprising a power source disposed in the internal chamber, wherein the power source supplies power to the illumination source and the first illumination controller.   The first illumination control unit includes a turning control unit, and the turning control unit has an axis and can move perpendicular to the axis, and the turning control unit generates a first signal type and is displaced The lighting device of claim 11, wherein the second signal type is generated.   And further comprising a microcontroller disposed within the internal chamber, the microcontroller receiving a first signal from the first illumination controller and a programming signal from a surgical console, the programming signal being 12. The lighting device of claim 11, causing the microcontroller to interpret the first signal as controlling an illumination color instead of the illumination level. A method for adjusting the lighting used in ophthalmic surgery,
Receiving an input from a user to adjust an illumination level provided by an illumination device having an elongate tubular member extendable into the vitreous chamber of the eye, the elongate tubular member comprising: An input that includes an optical fiber for providing illumination to the vitreous chamber extending into the elongate tubular member, wherein the input is received via an illumination control disposed on an external surface of the illumination device. Receiving the step,
Sending an electrical signal to the surgical console, wherein the surgical console is routed by the illumination subsystem of the console such that adjusted illumination reaches the vitreous chamber of the eye through the optical fiber. Adjusting the illumination provided, transmitting electrical signals;
Including a method.   The received input causes a radio identification (RFID) signal change and transmitting the electrical signal to the surgical console detects the change in the RFID signal received by a communication module of the surgical console. 20. The method of claim 19, comprising communicating the change to a lighting subsystem of the surgical console. Receiving the transmitted electrical signal at the surgical console;
Receiving a request to remap the transmitted electrical signal to control a second lighting aspect rather than a first lighting aspect, wherein the first lighting aspect is an illumination level; A second illumination mode is illumination color;
Remapping the transmitted electrical signal;
21. The method of claim 20, further comprising:

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